IT201900016001A1

IT201900016001A1 - Step and rehabilitation aid system for a hemiplegic patient.

Info

Publication number: IT201900016001A1
Application number: IT102019000016001A
Authority: IT
Inventors: Guido Danieli; Pasquale Greco; Gabriele Larocca; Francesco Rossi
Original assignee: Guido Danieli; Calabrian High Tech S R L
Priority date: 2019-09-10
Filing date: 2019-09-10
Publication date: 2021-03-10

Description

Varianti e aggiunte alla domanda di brevetto 102019000006903 del 16/05/2019 per un sistema di ausilio al passo e alla riabilitazione di un paziente emiplegico. Variations and additions to the patent application 102019000006903 of 16/05/2019 for a walking aid and rehabilitation system for a hemiplegic patient.

Stato dell’Arte. State of the art.

Nella citata domanda di brevetto, che presentava un discreto esame dello stato dell’arte, è stato descritto un sistema per la riabilitazione del passo di soggetti emiplegici dotato di motori e ruote multidirezionali, che aveva anche la caratteristica di poter variare la distanza tra i bordi laterali, consentendo al paziente di passare attraverso porte anche piuttosto strette, essendo il sistema in grado di accorgersi della porta grazie a sensori di prossimità ed agendo conseguentemente tramite un ulteriore motore dedicato appunto alla variazione di assetto. Il sistema era anche dotato di un paranco che consentiva di far passare il paziente dalla posizione di seduto a quella verticale, essendo il paziente stesso agganciato tramite una di quelle imbragature commerciali, composta da cinghie flessibili, usate anche per antinfortunistica. Tuttavia nel disegno presentato in tavola 1 il paranco stesso era posizionato sulla barra centrale di collegamento tra le due alzate, cosa che non si può fare se le alzate stesse sono fissate a due elementi la cui distanza può essere variata come descritto appunto nel brevetto citato. In the aforementioned patent application, which presented a fair examination of the state of the art, a system for the rehabilitation of the gait of hemiplegic subjects equipped with multidirectional motors and wheels was described, which also had the characteristic of being able to vary the distance between the edges side, allowing the patient to pass through even rather narrow doors, since the system is able to notice the door thanks to proximity sensors and consequently acting through an additional motor dedicated precisely to the change in attitude. The system was also equipped with a hoist that allowed the patient to pass from the sitting position to the vertical position, since the patient himself was hooked through one of those commercial slings, composed of flexible straps, also used for accident prevention. However, in the drawing presented in table 1 the hoist itself was positioned on the central connecting bar between the two risers, which cannot be done if the risers themselves are fixed to two elements whose distance can be varied as described in the cited patent.

Pertanto sembra opportuno fissare il paranco non già sull’elemento di collegamento tra le due alzate, non più presente in un sistema ad assetto variabile, ma alla parte frontale, con due cavi che da questa, tramite carrucole, siano portati fino alle estremità superiori delle alzate, e da qui convergano obliquamente fissandosi all’elemento di aggancio alle cinghie che assicurano la tenuta del paziente in posizione verticale. Therefore it seems appropriate to fix the hoist not already on the connecting element between the two risers, no longer present in a variable structure system, but to the front part, with two cables that from this, by means of pulleys, are carried up to the upper ends of the raised, and from here they converge obliquely, fixing to the attachment element to the straps that ensure the patient is held in a vertical position.

Naturalmente il sistema di controllo dovrà provvedere automaticamente alla variazione della lunghezza dei cavi tramite avvolgimento e svolgimento degli stessi allorché vi sia una variazione della larghezza della base, per compensare appunto tale variazione. Corrispondentemente sarà anche utile prevedere la possibilità che il manubrio si avvicini verso il paziente quando la larghezza diminuisce in modo che la distanza tra le barre laterali, chiamate anche alzate, e il manubrio rimanga costante. Per fare ciò sarà sufficiente montare un manubrio che possa scorrere orizzontalmente rispetto al supporto anteriore, e venga spinto indietro da una molla. Dentro poi alla parte centrale orizzontale del manubrio stesso (quella in cui può scorrere per avvicinarsi / allontanarsi dalle alzate laterali) vi sarà un cavo collegato a una puleggia (il cui profilo esatto sarà da determinare) solidale al motore che controlla l’allargamento restringimento della base. In tal modo quando viene variata la larghezza della base, viene anche variata la posizione del manubrio. Naturally, the control system must automatically provide for the variation in the length of the cables by winding and unwinding them when there is a variation in the width of the base, to compensate for this variation. Correspondingly it will also be useful to foresee the possibility that the dumbbell approaches the patient when the width decreases so that the distance between the side bars, also called risers, and the dumbbell remains constant. To do this it will be sufficient to mount a handlebar that can slide horizontally with respect to the front support, and is pushed back by a spring. Then inside the central horizontal part of the handlebar itself (the one in which it can slide to approach / move away from the side risers) there will be a cable connected to a pulley (whose exact profile will be determined) integral with the motor that controls the widening narrowing of the base. In this way, when the width of the base is changed, the position of the handlebar is also changed.

In alternativa poi al sistema commerciale a cinghie, si potrebbe pensare a un sistema di due supporti sotto-ascellari collegati tra loro frontalmente da una fibbia e collegati come nel caso precedente tramite cavi a due carrucole poste in cima alle alzate, sistema che forse potrebbe essere più agevole da indossare, restando comunque il resto del sistema come già descritto. Ovviamente vi potrebbe anche essere un collegamento posteriore tra i due supporti sotto-ascellari, per maggior sicurezza, e sempre ai supporto sotto-ascellari potrebbe essere anche collegato il manubrio, che sarebbe quindi sempre in posizione fissa rispetto al paziente, così come sarebbe possibile collegare il manubrio anche alle due alzate laterali, magari tenendolo sempre al centro con due molle di uguali caratteristiche collegato alle barre stesse. Come ulteriore ipotesi si potrebbe anche pensare che il supporto di sostegno della posizione verticale del paziente sia collegato alla parte frontale e non agli elementi laterali, anche se in questo caso il paziente sarebbe più libero di oscillare rispetto al sistema appoggiato a terra, perdendo un po’ in stabilità. Infine il paziente potrebbe anche essere voltato in modo da avere l’elemento di supporto del peso del paziente dietro anziché davanti, ma questo avrebbe l’effetto, molto negativo, di non permettere l’inserimento di una sedia a rotelle, da estrarre successivamente, in sede di carico del paziente. As an alternative to the commercial belt system, one could think of a system of two sub-axillary supports connected to each other frontally by a buckle and connected as in the previous case by means of two pulley cables placed at the top of the risers, a system that perhaps could be easier to wear, while the rest of the system remains as already described. Obviously there could also be a posterior connection between the two sub-axillary supports, for greater safety, and the handlebar could also be connected to the sub-axillary supports, which would therefore always be in a fixed position with respect to the patient, just as it would be possible to connect the handlebar also at the two side risers, perhaps always keeping it in the center with two springs of the same characteristics connected to the bars themselves. As a further hypothesis, it could also be thought that the support supporting the patient's vertical position is connected to the front part and not to the side elements, even if in this case the patient would be more free to swing than the system resting on the ground, losing a little 'in stability. Finally, the patient could also be turned so as to have the patient's weight support element behind instead of in front, but this would have the very negative effect of not allowing the insertion of a wheelchair, to be extracted later. when loading the patient.

Descrizione della realizzazione preferita. Description of the preferred embodiment.

Tavola 1 mostra appunto il sistema completo a geometria variabile, si notino il paranco (1) è posto in basso nella parte anteriore ed i due cavi tengono il paziente (2) sospeso tramite l’imbragatura (3) al centro tra le due alzate (4), nonché il manubrio (5) a distanza regolabile sia in altezza che in distanza dalle alzate, caratterizzato però dalla distanza costante dalle alzate una volta regolato. Table 1 shows the complete system with variable geometry, note the hoist (1) is placed at the bottom in the front and the two cables hold the patient (2) suspended by means of the sling (3) in the center between the two risers ( 4), as well as the handlebar (5) with adjustable distance both in height and in distance from the risers, characterized however by the constant distance from the risers once adjusted.

Tavola 2 mostra la stessa attrezzatura vista da sopra, senza il paziente, che evidenza la presenza dei parallelogrammi articolati (6). Tavola 2 mostra invece il sistema sotto-ascellare (7) sospeso alle due alzate, collegate in questo caso al manubrio (8), non più posto sull’elemento anteriore. Table 2 shows the same equipment seen from above, without the patient, showing the presence of the articulated parallelograms (6). Table 2 instead shows the sub-axillary system (7) suspended from the two risers, connected in this case to the handlebar (8), no longer placed on the front element.

In Tavola 3 si vede poi il manubrio (9) collegato alle alzate. In Table 3 we see then the handlebar (9) connected to the risers.

Claims

Claims 1. Gait rehabilitation system for hemiplegic patients consisting of a C-shaped platform under which independent motors are placed that act on multidirectional wheels on which a handlebar is mounted in a central position both in height and in distance from the patient, while on the side wings are placed raised, possibly connected at the top, to which an adjustable harness is connected such as those used to work safely on poles or trees which, by grasping the patient under the armpits, at the waist or under the horse, guarantees the impossibility of fall, since the system is also able to lift the patient from sitting to standing position by means of one or two winches, always using the sling, allowing the system to move in any direction, both following a precise therapeutic program established by the rehabilitator, which move at the command of the patient using a keypad or a small joystick that also contains the co command of the lifting winch, which can be positioned on one of the two handlebar handles, connected to the control unit via cable or also via bluetooth or wifi, allowing the patient full control of the motion, including the ability to turn right or left or also to turn on itself while, in the case of programmed therapy, while a touch screen allows both to enter the same program and to provide the patient with both visual and vocal indications on what to do, obviously being all powered by a rechargeable battery , and controlled by an electronic system that can also be connected both in wifi and in bluetooth with other systems present, as the system is also forced to stop automatically if the patient does not hold down one of the control buttons, to increase the safety level of the system; 2. Gait rehabilitation system for hemiplegic patients as per claim 1 in which three or four groups of multidirectional wheels and relative motors are placed under the base platform, able to also adapt to any irregularities of the floor on which it must move, being equipped with suspensions (if the wheels are four), while under the C-shaped structure in the case of using only three wheels with axles inclined at 120 ° there are also two pivoting wheels that do not touch the ground on the sides of the front central wheel , or even simply two pins in order to prevent the system from overturning; 3. Gait rehabilitation system for hemiplegic patients as per claim 1 in which the base platform is of variable width, thanks to the connection of the front central part with the side rails through two articulated quadrilaterals connected by two toothed wheels to which the task is entrusted to reverse their motion, so as to pass through the doors, since in this case the upper connection between the risers is absent and the handlebar is either able to slide horizontally or connected to the risers so as to remain at a constant distance from the patient, held centrally thanks to a spring of high elasticity, while the hoist is placed on the central front part to which two cables are connected which, by means of pulleys, are brought to the top of the risers in order to keep the patient always centered with respect to these, being also the system in degrees of automatically correct the pull of the ropes during the configuration change, in order to maintain the patient always supported at the same height; 4. Gait rehabilitation system for hemiplegic patients as per claim 1 in which the sling can be replaced by two sub-axillary supports connected by anterior and posterior straps which can also be connected to the handlebar, guaranteeing constant position with respect to the patient .